SEMAGLUTIDE (SEM a GLOO tide) promotes weight loss. It may also be used to maintain weight loss. It works by decreasing appetite. Changes to diet and exercise are often combined with this medication. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions

This medication is injected under the skin. You will be taught how to prepare and give it. Take it as directed on the prescription label. It is given once every week (every 7 days). Keep taking it unless your care team tells you to stop. It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or care team to get one. Ask your pharmacist if you have questions on how to use this medication. Read this information carefully. Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 12 years for selected conditions, precautions do apply. Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.

Side effects that you should report to your care team as soon as possible: Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat Change in vision Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine Gallbladder problems—severe stomach pain, nausea, vomiting, fever Heart palpitations—rapid, pounding, or irregular heartbeat Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting Thoughts of suicide or self-harm, worsening mood, feelings of depression Thyroid cancer—new mass or lump in the neck, pain or trouble swallowing, trouble breathing, hoarseness Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome): Diarrhea Loss of appetite Nausea Stomach pain Vomiting This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Refrigeration (required): Store vial in the refrigerator. Do not freeze. Keep this medication in the original container until you are ready to take it. Get rid of any unused medication after the expiration date. Your vial is good for approximately 28 days after the first puncture by the patient. For this reason, if a patient wants a three month supply, they must get three separate vials instead of one large vial with three months of medicine inside. Your dose may be injected while cold. Alternatively, you can draw the dose into your syringe and let the syringe sit at room temperature for 15 minutes prior to injecting. Some people find the injection more comfortable if done at room temperature.

They need to know if you have any of these conditions: Endocrine tumors (MEN 2) or if someone in your family had these tumors Eye disease, vision problems Gallbladder disease History of depression or mental health disease History of pancreatitis Kidney disease Stomach or intestine problems Suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member Thyroid cancer or if someone in your family had thyroid cancer An unusual or allergic reaction to semaglutide, other medications, foods, dyes, or preservatives Pregnant or trying to get pregnant Breast-feeding

Insulin and other medications for diabetes may interact. This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

If you miss a dose and the next scheduled dose is more than 2 days away, take the missed dose as soon as possible. If you miss a dose and the next scheduled dose is less than 2 days away, do not take the missed dose. Take the next dose at your regular time. Do not take double or extra doses. If you miss your dose for 2 weeks or more, take the next dose at your regular time or call your care team to talk about how to restart this medication.

Visit your care team for regular checks on your progress. It may be some time before you see the benefit from this medication. The dose is started out low and usually increases until your custom dose is achieved. This is done to minimize side effects. Drink plenty of fluids while taking this medication. Check with your care team if you have severe diarrhea, nausea, and vomiting, or if you sweat a lot. The loss of too much body fluid may make it dangerous for you to take this medication. Make sure you drink some zero-calorie electrolyte sports drinks if you are not eating much. This medication may affect blood sugar levels. Ask your care team if changes in diet or medications are needed if you have diabetes. If you or your family notice any changes in your behavior, such as new or worsening depression, thoughts of harming yourself, anxiety, other unusual or disturbing thoughts, or memory loss, call your care team right away. Women should inform their care team if they wish to become pregnant or think they might be pregnant. Losing weight while pregnant is not advised and may cause harm to the unborn child. Talk to your care team for more information. If you experience severe nausea or vomiting, please let your care team know. There are options to help relieve the side effects. Some people have reported success at relieving their nausea by taking over-the-counter Dramamine ginger capsules. Prescription anti-nausea meds such as ondansetron can be prescribed by your provider. Semaglutide slows down your digestive tract. Constipation is a common side effect of slowing down the digestive tract. Fiber and magnesium supplements can help with constipation. In rare cases, semaglutide use has been linked to gastroparesis and intestinal blockages. Contact your prescriber if you have not had a bowel movement in more than 3-4 days.

Losing weight can have many health benefits, including reducing the patient’s needs for other medications.If you are on blood pressure medicine, your dose may need to be adjusted, so it is important to check it regularly.Diabetics may find that their blood sugar medicine needs to be adjusted after weight loss. If you have co-occuring health conditions, make sure they are monitored regularly. Taking semaglutide alone and doing nothing else may lead to greater muscle loss than fat loss. It is important that you incorporate the Parkway Weight Loss Protocol into your daily routine. We cannot stress enough that it is necessary to do some moderate weight lifting to prevent muscle wasting. Drink plenty of fluids, including water and zero-calorie sports electrolyte drinks.